The question of recurrence of symptoms after surgical treatment of affections of the gallbladder and the biliary passages is one that has been much discussed during the past decade, and one which I believe will bear further consideration.

In 1916, reporting on more than a thousand operations on the gallbladder and the biliary passages in my service at the Lankenau (formerly the German) Hospital of Philadelphia, I found that 4.07 per cent. were reoperative cases (some of the patients having had three operations). Among 800 cases coming under my care in the same hospital since January, 1916, it appears that 8.5 per. cent. (seventy cases) were secondary (there were also a few tertiary) operations. Confronted with this increase in recurrence, we naturally turn to seek the cause.

Of the recent series, fifty-one patients were originally operated on elsewhere by other surgeons, the remaining nineteen having been operated on by me